Endometrial Stromal Sarcoma Development after Hysterectomy and Tamoxifen Therapy

2008 ◽  
Vol 74 (8) ◽  
pp. 726-728
Author(s):  
D. Benjamin Christie ◽  
J. Daniel Day ◽  
Amy B. Moore ◽  
Jason R. Chapman ◽  
Don K. Nakayama ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Breast Carcinoma ◽  
Adjuvant Therapy ◽  
Endometrial Stromal Sarcoma ◽  
Tamoxifen Therapy ◽  
Endometrial Cell ◽  
Uterine Sarcomas ◽  
Stromal Sarcoma ◽  
Uterine Tumors

Tamoxifen therapy is well known for its success in adjuvant therapy for breast carcinoma; however, despite its benefits, the agents’ estrogenic influence on the uterus, and subsequent endometrial cell proliferation may result in development of invasive uterine tumors. It has been estimated that tamoxifen may increase the risk of endometrial-based cancer two- to threefold, but uterine sarcomas remain relatively rare, accounting for 2 to 5 per cent of all uterine malignancies. We report the case of a 72-year-old woman having received tamoxifen for a breast carcinoma and having a hysterectomy nearly 30 years prior who presented with an intra-abdominal, omentum-based mass that on excision was identified as an endometrial stromal sarcoma.

scholarly journals Fusion genes in gynecologic tumors: the occurrence, molecular mechanism and prospect for therapy

2021 ◽  
Vol 12 (8) ◽  
Author(s):  
Bingfeng Lu ◽  
Ruqi Jiang ◽  
Bumin Xie ◽  
Wu Wu ◽  
Yang Zhao
Keyword(s):  
Tumor Progression ◽  
Massively Parallel Sequencing ◽  
Gynecologic Cancer ◽  
Endometrial Stromal Sarcoma ◽  
Driver Mutations ◽  
Fusion Genes ◽  
Stromal Sarcoma ◽  
Uterine Tumors ◽  
Rearrangement Mechanism ◽  
Gynecologic Tumors

AbstractGene fusions are thought to be driver mutations in multiple cancers and are an important factor for poor patient prognosis. Most of them appear in specific cancers, thus satisfactory strategies can be developed for the precise treatment of these types of cancer. Currently, there are few targeted drugs to treat gynecologic tumors, and patients with gynecologic cancer often have a poor prognosis because of tumor progression or recurrence. With the application of massively parallel sequencing, a large number of fusion genes have been discovered in gynecologic tumors, and some fusions have been confirmed to be involved in the biological process of tumor progression. To this end, the present article reviews the current research status of all confirmed fusion genes in gynecologic tumors, including their rearrangement mechanism and frequency in ovarian cancer, endometrial cancer, endometrial stromal sarcoma, and other types of uterine tumors. We also describe the mechanisms by which fusion genes are generated and their oncogenic mechanism. Finally, we discuss the prospect of fusion genes as therapeutic targets in gynecologic tumors.

A Clinical and Pathologic Study of 34 Sarcomas of the Uterus

1981 ◽  
Vol 67 (4) ◽  
pp. 341-348 ◽  
Author(s):  
Rado Kenda ◽  
Giuseppe De Palo ◽  
Salvatore Andreola ◽  
Gaetano Bandieramonte ◽  
Giovanni Lupi ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Endometrial Stromal Sarcoma ◽  
Controlled Clinical Trials ◽  
Relapse Free Survival ◽  
Histologic Subtype ◽  
Uterine Sarcomas ◽  
Free Survival ◽  
Stromal Sarcoma ◽  
Pathologic Features ◽  
History Of

The clinical and pathologic features of 34 uterine sarcomas were studied to determine the natural history of the disease. Sixteen patients had leiomyosarcoma, five mixed mesodermal sarcoma, ten endometrial stromal sarcoma, two carcinosarcoma and one endolymphatic stromal myosis. The patients were treated without an unique protocol. At 3 years the actuarial relapse-free survival was 53.6 %: 68.4 % in stage I-II patients and 22.2 % in stage III-IV patients. As regards the histologic subtype mixed mesodermal sarcomas had the best prognosis; endometrial stromal sarcomas the worst. The necessity of a uniform clinical and histologic classification as well as the importance of controlled clinical trials are pointed out.

scholarly journals Isobolographic Analysis Demonstrates the Additive and Synergistic Effects of Gemcitabine Combined with Fucoidan in Uterine Sarcomas and Carcinosarcoma Cells

Cancers ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 107 ◽  
Author(s):  
Marcin Bobiński ◽  
Karolina Okła ◽  
Jarogniew Łuszczki ◽  
Wiesława Bednarek ◽  
Anna Wawruszak ◽  
...  
Keyword(s):  
Cell Cycle ◽  
Synergistic Effect ◽  
Cell Line ◽  
Cell Lines ◽  
Combined Treatment ◽  
Endometrial Stromal Sarcoma ◽  
Uterine Leiomyosarcoma ◽  
Uterine Sarcomas ◽  
Isobolographic Analysis ◽  
Stromal Sarcoma

Background: Uterine sarcomas and carcinosarcoma are associated with unfavorable prognosis. The regimens that are used in chemotherapy are associated with high incidence of side effects and usually do not significantly increase patients’ survival rates. In this study we investigated the activity and interactions between gemcitabine and fucoidan, the natural compound known for its anti-tumor properties, in human sarcomas and carcinosarcoma cell models. Methods: SK-UT-1, SK-UT1-B (carcinosarcoma), MES-SA (leiomyosarcoma), and ESS-1 (endometrial stromal sarcoma) cell lines were used for the experiments. Cells were incubated in the presence of gemcitabine, fucoidan, and mixtures, after the incubation the MTT tests were performed. In order to assess the interactions between tested compounds isobolographic analysis was performed. Additional assessments of apoptosis and cell cycle were done. Results: Additive effect of combined treatment with gemcitabine and fucoidan was observed in ESS-1 and SK-UT-1 cell line. Although the supra-additive (synergistic) effect noticed in SK-UT-1B cell line. It was not possible to determine the interactions of fucoidan and gemcitabine in MES-SA cell line due to insufficient response to treatment. Addition of fucoidan to gemcitabine enhances its proapoptotic activity, what was observed especially in ESS-1 and SK-UT-1B cell lines. The arrest of cell cycle induced by mixture of gemcitabine and fucoidan, superior comparing gemcitabine alone was observed in SK-UT-1B. Conclusions: Obtained data showed that a combination of fucoidan and gemcitabine in uterine endometrial stromal sarcoma and carcinosarcoma cell lines has additive or even synergistic effect in decreasing cell viability. Furthermore, this drug combination induces apoptosis and arrest of cell cycle. The resistance of uterine leiomyosarcoma cell line, justifies searching for other drugs combinations to improve therapy efficacy.

High-Grade Endometrial Stromal Sarcoma after Tamoxifen Therapy for Breast Cancer

2005 ◽  
Vol 60 (2) ◽  
pp. 117-120 ◽  
Author(s):  
Francesco Sesti ◽  
Lodovico Patrizi ◽  
Beatrice Ermini ◽  
Giampiero Palmieri ◽  
Augusto Orlandi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Endometrial Stromal Sarcoma ◽  
Tamoxifen Therapy ◽  
High Grade ◽  
Stromal Sarcoma

Uterine Sarcoma and Aromatase Inhibitors: Tom Baker Cancer Centre Experience and Review of the Literature

2012 ◽  
Vol 22 (6) ◽  
pp. 1006-1012 ◽  
Author(s):  
Alon D. Altman ◽  
Gregg S. Nelson ◽  
Pamela Chu ◽  
Jill Nation ◽  
Prafull Ghatage
Keyword(s):  
Partial Response ◽  
Aromatase Inhibitors ◽  
Retrospective Studies ◽  
Response Rate ◽  
Case Reports ◽  
Endometrial Stromal Sarcoma ◽  
Uterine Sarcoma ◽  
Uterine Sarcomas ◽  
Cancer Centre ◽  
Stromal Sarcoma

ObjectivesUterine sarcomas are a rare group of mesenchymal tumors with a poor prognosis and aggressive biology. Standard treatment involves surgical staging. The role of further adjuvant treatment is unclear. The goals of this study were to determine the response rates to treatment of patients with uterine sarcomas and to review the currently available literature on the use of aromatase inhibitors (AIs).Materials and MethodsWe performed a retrospective analysis on all patients with uterine sarcoma treated with an AI between 2000 and 2010 at the Tom Baker Cancer Centre in Calgary, Alberta.ResultsFour patients with endometrial stromal sarcoma and 3 patients with leiomyosarcoma received treatment with an AI. A literature search resulted in 10 case reports and 4 retrospective studies of patients with endometrial stromal sarcoma and 1 case report and 2 retrospective studies of patients with leiomyosarcoma. On the basis of the available literature, combined with the current findings, the overall response rate of endometrial stromal sarcoma to AIs is 67% (complete response of 7% and partial response of 60%), and the partial response rate of leiomyosarcoma to AIs is 11%, with no reported complete responses.ConclusionsAromatase inhibitors are a well-tolerated class of medications that are effective in the treatment of endometrial stromal sarcomas. These medications may also have a role to help stabilize disease progression in the treatment of leiomyosarcoma. More large, prospective, multicentered trials will be needed to clarify this issue.

scholarly journals Pleural Metastasis of High-Grade Endometrial Stromal Sarcoma With YWHAE Gene (17p13.3) Rearrangement, A Rare Case Report

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S41-S41
Author(s):  
A C Re ◽  
M Enrique ◽  
S Ren
Keyword(s):  
Case Report ◽  
Spindle Cell ◽  
Malignant Neoplasm ◽  
Endometrial Stromal Sarcoma ◽  
Low Grade ◽  
High Grade ◽  
Stromal Sarcoma ◽  
Uterine Tumors ◽  
Uterine Neoplasm ◽  
Left Pleural Effusion

Abstract Introduction/Objective Endometrial stromal sarcoma (ESS), a rare malignant neoplasm of endometrial stroma, accounts for less than 1% of all uterine tumors. High grade ESS (HGESS) is aggressive and commonly relapses even after surgical and neoadjuvant therapy. Abdominal and pelvic regions are common sites of metastasis, however, distant metastases to the liver, lung, vertebrae, and brain have been reported. Methods/Case Report We encountered a 49-year-old female who presented with shortness of breath, found to have a left pleural effusion and multiple pleural masses. She initially presented three years ago with heavy irregular menses and left pelvic pain for one year. D&C revealed prominent small spindle cells for which a stromal nodule and low-grade or malignant process was probable. CT scan showed an enlarged uterus. Hysterectomy with bilateral salpingo- oophorectomy, bilateral pelvic and para-aortic lymph node dissection, and partial omentectomy were performed. The uterus revealed an intramural 7 cm mass with a serpiginous growth pattern and lymphovascular invasion. Tumor cells were plump to spindled with areas of high cellularity, rounded nuclei, increased atypia and mitosis. Atypical areas were positive for cyclin D1, focally positive for CD10, and negative for ER, PR, SMA, desmin, AE1/3 and CAM5.2. FISH studies showed rearrangement of YWHAE gene (17p13.3) and no rearrangement of JAZF1 or PHF1 gene regions. Findings supported the diagnosis of HGESS. The patient received post-operative chemotherapy. Biopsy of the current pleural lesion revealed a nonspecific malignant spindle cell neoplasm positive for BCL1, CD56, CD117, CD99, TLE1 and INI1, while negative for AE1/3, CAM5.2, EMA, ER, PR, CK5/6, calretinin, SMA, desmin and S100. The CD10 stain was inconclusive. FISH studies showed rearrangement of YWHAE gene (17p13.3) and no rearrangement involving JAZF1 or PHF1 gene regions. No rearrangement of the SS18 gene region was observed and synovial sarcoma was excluded. Overall findings support the diagnosis of metastatic HGESS. Results (if a Case Study enter NA) NA Conclusion HGESS, a rare tumor with a nonspecific immunostain profile, has the ability to metastasize to rare body sites, such as the pleura in our case. Display of spindle cell morphology is a nonspecific finding that raises broad differential diagnoses. In women, with or without a history of uterine neoplasm, HGESS is a clinically worthwhile diagnosis to be mindful of.

High-grade endometrial stromal sarcoma after treatment with tamoxifen in a patient treated for breast cancer

2003 ◽  
Vol 13 (5) ◽  
pp. 690-692 ◽  
Author(s):  
Y. Saga ◽  
M. Ohwada ◽  
T. Kohno ◽  
N. Takayashiki ◽  
M. Suzuki
Keyword(s):  
Breast Cancer ◽  
Endometrial Stromal Sarcoma ◽  
Tamoxifen Therapy ◽  
Low Grade ◽  
High Grade ◽  
Stromal Sarcoma ◽  
Endometrial Epithelium ◽  
Sarcoma Cells ◽  
Disease Free

Tamoxifen has been widely used in breast cancer treatment. In recent years, the occurrence of uterine malignancies in patients receiving long-term tamoxifen therapy has attracted attention. Most of these malignancies are endometrial adenocarcinomas, but low-grade endometrial stromal sarcomas have occasionally been reported. Here we report a woman who developed a high-grade endometrial stromal sarcoma after receiving postmastectomy tamoxifen therapy. The patient underwent a left mastectomy at age 45 and subsequently received oral tamoxifen for 3 years. At age 51, she was diagnosed with endometrial stromal sarcoma, for which a radical hysterectomy was performed. High-grade endometrial stromal sarcoma was diagnosed by postoperative histologic examination. Immunostaining for the estrogen receptor was negative in sarcoma cells, but positive in the residual endometrial epithelium and the nucleus of adjacent stromal cells within the tumor. The patient has now survived disease-free for 37 months after surgery.

Localized high grade endometrial stromal sarcoma and localized undifferentiated uterine sarcoma: a retrospective series of the French Sarcoma Group

2019 ◽  
Vol 29 (4) ◽  
pp. 691-698 ◽  
Author(s):  
Marie Meurer ◽  
A Floquet ◽  
I Ray-Coquard ◽  
F Bertucci ◽  
M Auriche ◽  
...  
Keyword(s):  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Radiotherapy ◽  
Disease Free Survival ◽  
Endometrial Stromal Sarcoma ◽  
High Grade ◽  
Uterine Sarcomas ◽  
Free Survival ◽  
Stromal Sarcoma ◽  
Disease Free

ObjectiveHigh grade endometrial stromal sarcoma and undifferentiated uterine sarcomas are associated with a very poor prognosis. Although large surgical resection is the standard of care, the optimal adjuvant strategy remains unclear.MethodsA retrospective analysis of patients with localized high grade endometrial stromal sarcoma and undifferentiated uterine sarcomas (stages I–III) treated in 10 French Sarcoma Group centers was conducted.Results39 patients with localized high grade endometrial stromal sarcoma and undifferentiated uterine sarcomas treated from 2008 to 2016 were included. 24/39 patients (61.5%) were stage I at diagnosis. 38/39 patients underwent surgical resection, with total hysterectomy and bilateral oophorectomy completed in 26/38 (68%). Surgeries were mostly resection complete (R0, 23/38, 60%) and microscopically incomplete resection (R1, 6/38, 16%). 22 patients (58%) underwent postoperative radiotherapy (including brachytherapy in 11 cases), and 11 (29%) underwent adjuvant chemotherapy. After a median follow-up of 33 months (range 2.6–112), 17/39 patients were alive and 21/39 (54%) had relapsed (9 local relapses and 16 metastases). The 3 year and 5 year overall survival rates were 49.8% and 31.1%, respectively, and 3 year and 5 year disease free survival rates were 42.7% and 16.0%, respectively. Median overall survival and disease free survival were 32.7 (95% CI 16.3–49.1) and 23 (4.4–41.6) months, respectively. Medians were, respectively, 46.7 months and 39.0 months among those who underwent adjuvant radiotherapy and 41.0 months and 10.3 months for those who underwent adjuvant chemotherapy. In multivariate analysis, adjuvant radiotherapy was an independent prognostic factor for overall survival (P=0.012) and disease free survival (P=0.036). Chemotherapy, International Federation of Gynecology and Obstetrics I–II stages, and Eastern Cooperative Oncology Group-performance status 0 correlated with improved overall survival (P=0.034, P=0.002, P=0.006), and absence of vascular invasion (P=0.014) was associated with better disease free survival.ConclusionsThe standard treatment of primary localized high grade endometrial stromal sarcoma and undifferentiated uterine sarcomas is total hysterectomy and bilateral oophorectomy. The current study shows that adjuvant radiotherapy and adjuvant chemotherapy appear to improve overall survival. A prospective large study is warranted to validate this therapeutic management.

Sign in / Sign up

Export Citation Format

Share Document